Nephrosclerosis


Figure A. PAS x40

Figure B. Trichrome x20

Figure C. C4d

Figure D. C4d

 

 

   

 

Clinical History: 24 year old female with history of biopsy proven membranous nephropathy, who had partial remission with x2 recurrences. Rapidly progressive CKD (creatinine = 5.8 mg/ dL). All autoimmune serology is negative but she has low C4 (<8 and 12.6mg/dL) which is suggestive of C4 glomerulonephritis.

Histology: Glomeruli demonstrate mild to moderate mesangial matrix expansion with minimal increased cellularity, as evaluated by PAS stain (Figure A). There is thickening of capillary loop basement membranes. There is also thickening of Bowman’s capsule and trichrome stain highlights severe interstitial fibrosis with associated tubular atrophy (Figure B). Special Immunohistochemical stain for C4d shows glomeruli with abundant positive granular deposits (Figure C, D)


(Last Edition: February 21, 2024 )